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引导骨再生治疗拔牙窝组织新生的分析:临床、组织学及显微CT结果

Analysis of tissue neogenesis in extraction sockets treated with guided bone regeneration: clinical, histologic, and micro-CT results.

作者信息

Neiva Rodrigo, Pagni Giorgio, Duarte Frederico, Park Chan Ho, Yi Erica, Holman Lindsay A, Giannobile William V

机构信息

Department of Periodontology, College of Dentistry, University of Florida, Gainesville, Florida 32610-0434, USA.

出版信息

Int J Periodontics Restorative Dent. 2011 Sep-Oct;31(5):457-69.

Abstract

The aims of this article were to perform a detailed evaluation of the healing of extraction sockets covered with a resorbable collagen membrane 12 weeks following exodontia and to determine if this device had ossifying properties. Ten consecutive subjects in need of extraction of maxillary premolars were recruited. Each subject had a hopeless maxillary premolar extracted with minimal trauma. Sockets were then covered with a collagen barrier membrane alone. At 12 weeks, reentry surgery was performed, clinical measurements were repeated, and bone core biopsies were obtained prior to dental implant placement for histologic and microcomputed tomography (micro-CT) analysis. Study sites showed mean bone regeneration horizontally of 7.7 mm (buccopalatally) and 4.6 mm (mesiodistally). Vertical bone repair showed a mean gain of 10.9 mm. Subtraction radiography showed a mean apical shift of the crestal bone at the center of the socket of 2.1 mm (range, 0.7 to 4.3 mm). Micro-CT and histology revealed formation of well-mineralized tissue at 12 weeks, with a mean percentage of vital bone of 45.87% ± 12.35%. No signs of membrane ossification were observed. A detailed analysis of tissue neogenesis in extraction sites protected by this barrier membrane has demonstrated that adequate bone formation for implant placement occurs as early as 12 weeks following exodontia, with minimal changes in alveolar ridge dimensions. No evidence of membrane ossification was observed.

摘要

本文的目的是在拔牙后12周对覆盖可吸收胶原膜的拔牙窝愈合情况进行详细评估,并确定该装置是否具有骨化特性。招募了连续10名需要拔除上颌前磨牙的受试者。每位受试者的上颌前磨牙在创伤最小的情况下被拔除。然后仅用胶原屏障膜覆盖拔牙窝。在12周时,进行再次手术,重复临床测量,并在植入牙种植体前获取骨芯活检样本,用于组织学和显微计算机断层扫描(micro-CT)分析。研究部位水平方向的平均骨再生为7.7毫米(颊舌向)和4.6毫米(近远中向)。垂直骨修复的平均增加量为10.9毫米。减影放射成像显示,牙槽窝中心嵴顶骨的平均根尖移位为2.1毫米(范围为0.7至4.3毫米)。Micro-CT和组织学显示,在12周时形成了矿化良好的组织,活骨的平均百分比为45.87%±12.35%。未观察到膜骨化的迹象。对受该屏障膜保护的拔牙部位组织新生的详细分析表明,拔牙后12周时就出现了足以植入种植体的骨形成,牙槽嵴尺寸变化最小。未观察到膜骨化的证据。

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